Universal Early Gestational Diabetes Mellitus Screening: A Prospective Multicenter Study in Thailand
Metha Songthamwat¹, Rawisara Champawong², Srisuda Songthamwat³, Siriluk Norsuwan⁴, Pimjai Maleerat⁵, Chatchanawade Na Nan⁶, Koollachart Saejueng⁷, Nopporn Limwatanapan⁸, Anuchat Sujita⁹
Affiliation : ¹ Department of Obstetrics and Gynecology, Udonthani Hospital, Udon Thani, Thailand; ² Na Klang Hospital, Nong Bua Lamphu, Thailand; ³ Phetchabun Hospital, Phetchabun, Thailand; ⁴ Kumpawapi Hospital, Udon Thani, Thailand; ⁵ Ban Phue Hospital, Udon Thani, Thailand; ⁶ Phen Hospital, Udon Thani, Thailand; ⁷ Ban Dung Hospital, Udon Thani, Thailand; ⁸ Wanon Niwat Hospital, Sakon Nakhon, Thailand; ⁹ Nong Han Hospital, Udon Thani, Thailand
Objective: To study the prevalence of early-onset gestational diabetes mellitus (GDM) and clinical characteristics from universal early antenatal screening in Thai pregnant women.
Materials and Methods: A multicenter prospective study in multi-level of hospitals in Thailand was conducted between May and September 2024. All pregnant women attending antenatal clinic before 20 weeks of gestation were screened for GDM using the two-step method. A 50-g glucose challenge test (GCT) at first antenatal care followed by a diagnostic 100-g oral glucose tolerance test (OGTT). The glucose screening test was repeated between 24 and 28 weeks if the earlier testing was negative. The prevalence of early-onset GDM and their clinical characteristics of GDM were evaluated.
Results: Eight hundred eighty-four pregnant women participated in the present study. The participants were found to have low, intermediate, and high risk of GDM of 19.46%, 42.31%, and 38.24%, respectively. The prevalence of early-onset GDM was 11.09% (95% CI 9.09 to 13.34). The glucose screening test was positive in 22.09%, 21.39%, and 42.01%, and the early-onset GDM was detected in 3.49%, 6.68%, and 19.82% of the low, intermediate, and high-risk groups, respectively. The significant associated factors of early-onset GDM were maternal age of 35 years or older, maternal age between 25 and 34 years, BMI of 30 kg/m² or more, a first degree relative with diabetes, and history of GDM in previous pregnancy.
Conclusion: Universal early GDM screening in Thailand can detect a high prevalence of GDM in asymptomatic pregnant women. The early detection leads to early control of blood glucose levels. However, the impact of this protocol still needs further investigation.
Received 20 December 2024 | Revised 8 April 2025 | Accepted 28 April 2025
DOI: 10.35755/jmedassocthai.2025.6.464-469-02420
Keywords : Gestational diabetes; Early-onset; Universal screening; Prevalence; Associated factors
